Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $213.80 / $213.80 / $288.40	Facility		$213.80	$213.80	$288.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $154.88 / $407.38	Professional		$97.72	$154.88	$407.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $199.53 / $891.25	Professional		$186.21	$199.53	$891.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Facility		$186.21	$186.21	$186.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $194.98 / $354.81	Professional		$123.03	$194.98	$354.81
Kaiser Permanente Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $177.83 / $302.00	Facility		$112.20	$177.83	$302.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $173.78 / $288.40	Professional		$109.65	$173.78	$288.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $93.33	Professional		$32.36	$33.11	$93.33
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $234.42 / $239.88	Facility		$194.98	$234.42	$239.88
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $251.19 / $331.13	Professional		$154.88	$251.19	$331.13
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $229.09 / $309.03	Professional		$165.96	$229.09	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $173.78 / $288.40	Professional		$120.23	$173.78	$288.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $112.20 / $199.53	Professional		$107.15	$112.20	$199.53